OptiCare Managed Vision - Notice of Privacy Practices

OptiCare Managed Vision (OMV) takes seriously the privacy interests of our membership, as we know you do. As an eye health managed care organization, we want you to understand how we protect members’ confidential information.

We protect all confidential information we have about our members and disclose only the information that is legally and contractually appropriate. Our membership has the right to expect its legally protected privacy interests will be respected and protected by OMV.

Our Member Confidentiality Policy is intended to comply with applicable state and federal laws and regulations, and the accreditation standards of the National Committee for Quality Assurance. If these requirements and standards change, we will review and revise our policy. We also may change our policy (as allowed by law) as necessary to better serve our membership.

To make sure that our policy is effective, we have designated a Corporate Compliance Officer who is charged with approving and reviewing OMV’s privacy and confidentiality standard operations procedures. This officer is responsible for the oversight, implementation, and monitoring of our policy.

OMV’s Core Privacy Principles:

We will protect Member confidential information and will not disclose any personal information to any external party except as we describe in our policy or as permitted or required by law or regulation.

Members have a right to request restrictions in writing on the uses and disclosures of their confidential member information. However, OMV is not required to agree with a requested restriction.

Each of our employees must sign a confidentiality statement when they begin employment with us, asserting they will abide by our policy. Only employees who have legitimate business needs to use Member confidential information will have access to such information.

When we use outside parties to perform work for us, we require these contractors to sign their own confidentiality agreements, stating they will protect member confidential information.

We also require the same kind of confidentiality agreement with our contracted providers.

We disclose member confidential information only where: required or permitted by law; or we obtain a separate authorization from the Member for specific purposes. All disclosures we make are permitted or required by law. These disclosures include those for health care treatment and payment, our company’s health care operations, various areas where the Member’s consent is not needed for certain public purposes (such as public health emergencies), and certain other health care purposes such as coordination of medical care, quality assessment and measurement, and accreditation. In a limited number of situations beyond these areas, we will seek a Member’s separate authorization for a specific purpose.

Members have the right to review certain records held in our possession. If Members wish to review records containing confidential information about them from the previous six years, they must submit a written request for copies of the information (we may charge a fee to obtain these copies).

Members have the right to request an amendment to their confidential information. Such requests must be made in writing.

If members have questions or concerns about the accuracy or completeness of information we have about them, Members should contact us in writing to tell us about their concerns. We will make the appropriate changes, as may be required by law. If a provider or someone other than us created the information, then we will direct the Member to that person to make the corrections.

Prior to responding to a phone request for Member confidential information, the caller will be asked to provide identifying information to reduce the possibility of a disclosure of Member confidential information to an unauthorized individual.

Individuals seeking Member confidential information will be required to submit Consent for Release of Medical Information form signed by the Member or his/her parent/guardian.

A person who believes OMV is not complying with these requirements may file a complaint with the OMV Corporate Compliance Officer, in accordance with the following protocol:
- A complaint must be filed in writing, either on paper or electronically.
- A complaint must name the entity that is the subject of the complaint and describe what is believed to be the violation.
- A complaint must be filed within 180 days of when the complainant knew or should have known that the act or omission complained of occurred, unless the HHS Secretary, for good cause shown, waives this time limit.
- OMV Corporate Compliance Officer may be contacted at the following address:
  - Corporate Compliance Officer
    OptiCare Managed Vision
    P.O. Box 7548
    112 Zebulon Court
    Rocky Mount NC 27804
A person who believes OMV is not complying with these requirements may file a complaint with the HHS Secretary, in accordance with the following protocol:
- A complaint must be filed in writing, either on paper or electronically.
- A complaint must name the entity that is the subject of the complaint and describe what is believed to be the violation.
- A complaint must be filed within 180 days of when the complainant knew or should have known that the act or omission complained of occurred, unless the HHS Secretary, for good cause shown, waives this time limit.
- HHS Secretary may be contacted at the following address and phone number:
  - The U.S. Department of Health and Human Services
    200 Independence Avenue, S.W.
    Washington, D.C. 20201
    (202) 619-0257
    Toll Free: 1-877-696-6775